469 Atlantic Blvd #2 plbg permit CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
lob ID: 17-PLBG-3200
lob Type: PLUMBING ONLY
Description: 2 Fixtures; Body Piercing Shap Unit 2.
Estimated Value:
Issue Date: 2/7/2017
Expiration Date: 8/6/2017
PROPERTY ADDRESS:
Address: 469 ATLANTIC BLVD UNIT 02
RE Number: None
PROPERTY OWNER:
Name: DIAMOND REAL ESTATE PROPERTIES
Address: 6517 LOU DRIVE S
GENERAL CONTRACTOR INFORMATION:
Name: FOUR STAR PLUMBING COMPANY
,CFC056689
Address: 40 W 16TH ST QA ROBERT JAMES FLORNOY
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $14.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
/Z/- p A Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: T C / �'i 7-,/— A'1t C A6 I l d PERMIT
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFlXTORE QTY TYPE OFF/XTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory `_ Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE of FixTuRE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
**S/RWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
this application and know the same to be true and cancer. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name 1 E C I �0 f Phone Number
Plumbing Company Q ��k 0,14q4�ititl Office Phone 90Y-n3-,,UQ Fax
Co.Address: I/,,A 5`7 City — )Ax State r'• zip 3-22--
License
z2aLicense Holder(Print): �7Of-N O State Certification/Registration#
Notarized Signature of License Holder
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